肾移植患者环孢素A的血药浓度监测

Cardiac supperssive effect of cyclosporine A in renal transplantation patients

采用高效液相色谱法（ＨＰＬＣ）对６８例肾移植患者进行了１９６次环孢素Ａ（ＣｓＡ）血药浓度测定。结果表明：肾移植术后３个月内病人ＣｓＡ血药浓度谷值为（３９５±２４５）μｇ／Ｌ（口服ＣｓＡ每ｄ７～９ｍｇ／ｋｇ），随时间变化，ＣｓＡ剂量逐渐减少，肾移植１２个月后ＣｓＡ血药浓度谷值下降到（２２５±５２）μｇ／Ｌ。患者之间存在显著的个体差异。提示：ＨＰＬＣ法测定ＣｓＡ血药浓度方法精确，且不受代谢物的影响；ＣｓＡ血药浓度监测对制定给药方案、肾毒性和排斥反应的鉴别，有重要的临床意义。

Cyclosporine A(CsA) in whole blood was measured with HPLC in 196 samples from 68 renal transplantation patients. The results showed that CsA blood concentration was (395±245) μg/L within the first 3 months after transplantation(oral dose of CsA 7～9mg·kg-1·d-1). The dosage of CsA reduced with the changing of time, and CsA blood concentration decreased to(225±52)μg/L 12 months after renal transplantation. CsA blood concentration varied significantly with individuals. The results suggest that the use of HPLC for the measurement of CsA blood concentration may be accurate , and not be affected by its metabolites. CsA therapeutic drug monitoring has great significance on drafting the clinical protocols for CsA and differentiation of the nephrotoxicity and allograft rejection.